The impact of a standard enforcement safety belt law on fatalities and hospital charges in Ohio

Introduction

The purpose of this study was to analyze linked crash and hospital data to determine the effect that enactment of a standard enforcement safety belt law in Ohio would have on hospital charges and direct medical costs due to motor-vehicle crashes, focusing on the impact to the state's Medicaid system.

Method

The linkage and analysis was conducted as part of the Ohio Crash Outcome Data Evaluation System (CODES) program. Current safety belt usage in Ohio stands at 82% with its secondary enforcement safety belt law.

Results

Assuming an increase in usage to 92% through standard enforcement, over $15.3 million in medical costs to Medicaid for injuries that occur in a single year could be prevented over a 10-year period. Cumulative savings could reach more than $91.2 million during the 10-year period. In addition, 161 fatalities could have been prevented in one year had all unbelted occupants who sustained a fatal injury instead chosen to wear their safety belt.

Summary and Impact on Industry

Clearly, substantial progress can be made in reducing the number of deaths and injuries, as well as medical costs associated with motor-vehicle crashes, by strengthening safety belt laws and increasing safety belt usage in Ohio.     

Effect of enhanced seat belt reminders on driver fatality risk

Objective

Enhanced seat belt reminders in automobiles have been shown to increase belt use rates by approximately 3 percentage points. The objective of this study was to estimate the effect of enhanced seat belt reminders on driver fatality risk.

Method

Data included all passenger vehicle driver deaths and vehicle registration counts in the United States for calendar years 2000-2007. Driver fatality rates per vehicle registration per year were compared for otherwise identical vehicle models with and without enhanced seat belt reminders.

Results

Driver fatality rates were 6% lower for vehicles with enhanced seat belt reminders compared with vehicles without enhanced belt reminders. After adjusting for vehicle age differences, the estimated effect of enhanced belt reminders on driver fatality risk ranged from a 9% reduction for General Motors vehicles to a 2% increase for Honda vehicles. Combining all manufacturers, enhanced belt reminders reduced fatality risk by approximately 2%. Although not statistically significant, the 2% reduction in fatality risk agrees with what should be expected from a 3 percentage point increase in seat belt use rates.

Conclusions

Enhanced seat belt reminders have raised driver belt use rates and reduced fatality rates, but more aggressive systems may be needed for some drivers. It can be inferred that nonfatal injury rates also have been reduced.

Impact on Industry

Manufacturers should be encouraged to put enhanced seat belt reminders on all vehicles as soon as possible.     

Does the metal content in soil around a pregnant woman’s home increase the risk of low birth weight for her infant?

Low birth weight (LBW) is associated with a number of maternal environmental exposures during pregnancy. This study explored the association between soil metal concentrations around the home where the mother lived during pregnancy and the outcome of LBW. We used a retrospective cohort of 9,920 mother–child pairs who were insured by Medicaid during pregnancy and lived in ten residential areas, where we conducted soil sampling. We used a grid that overlaid the residential areas and collected soil samples at the grid intersections. The soil was analyzed for the concentration of eight metals [arsenic (As), barium (Ba), chromium (Cr), copper (Cu), lead (Pb), manganese (Mn), nickel (Ni), and mercury (Hg)], and we then used Bayesian Kriging to estimate the concentration at the actual maternal addresses, since we had the GIS coordinates of the homes. We used generalized additive modeling, because the metal concentrations had nonlinear associations with LBW, to develop the best fitting multivariable model for estimating the risk of LBW. The final model showed significant associations for female infants, maternal smoking during pregnancy, non-white mothers, Cu, and As with LBW. The As variable was nonlinear in relation to LBW, and the association between higher concentrations of As with LBW was strong (p = 0.002). We identified a statistically significant association between soil concentrations of arsenic around the home of pregnant women and an increased risk of LBW for her infant.     

Associations between soil lead concentrations and populations by race/ethnicity and income-to-poverty ratio in urban and rural areas

Lead (Pb) is a well-studied environmental contaminant that has many negative health effects, especially for children. Both racial/ethnic and income disparities have been documented with respect to exposure to Pb in soils. The objectives of this study were to assess whether soil Pb concentrations in rural and urban areas of South Carolina USA, previously identified as having clusters of intellectual disabilities (ID) in children, were positively associated with populations of minority and low-income individuals and children (≤6 years of age). Surface soils from two rural and two urban areas with identified clusters of ID were analyzed for Pb and concentrations were spatially interpolated using inverse distance weighted analysis. Population race/ethnicity and income-to-poverty ratio (ITPR) from United States Census 2000 block group data were aerially interpolated by block group within each area. Urban areas had significantly higher concentrations of Pb than rural areas. Significant positive associations between black, non-Hispanic Latino, individuals and children ≤6 years of age and mean estimated Pb concentrations were observed in both urban (r = 0.38, p = 0.0007) and rural (r = 0.53, p = 0.04) areas. Significant positive associations also were observed between individuals and children with an ITPR < 1.00 and Pb concentrations, though primarily in urban areas. Racial/ethnic minorities and low ITPR individuals, including children, may be at elevated risk for exposure to Pb in soils.     

Estimating the influence of overhead transmission power lines and landscape context on the density of little bustard Tetrax tetrax breeding populations

Collision with conductors and earth cables is a known impact generated by transmission power lines, however there is virtually no information on how these infrastructures might affect bird distribution in a landscape context. With this work we specifically hypothesise that transmission power lines may affect the occurrence of a threatened bird, the little bustard (Tetrax tetrax). To test this hypothesis we used a Stochastic Dynamic Methodology (StDM), analysing the effects of power lines in a landscape perspective and simulating population trends as a response to power line installation and habitat changes induced by agricultural shifts in southern Portugal. The data used in the dynamic model construction included relevant gradients of environmental conditions and was sampled during the breeding seasons of 2003-2006. Transmission power lines were significantly avoided by the little bustard and the developed StDM model showed that the distance to these utility structures is the most important factor determining breeding densities in sites with suitable habitat for the species, which possibly leads to displacement of populations and habitat fragmentation. The model simulations also provided the base to analyse the cumulative effects caused by the habitat degradation that can ultimately lead to the extinction of local populations. Within priority conservation sites, the dismantling of existing transmission lines should be considered whenever possible, in order to ensure adequate breeding habitat. The model is considered useful as an auxiliary tool to be used in environmental impact assessments, management and conservation studies.     

An integrated approach: managing resources for post-disaster reconstruction

A lack of resources for post-disaster housing reconstruction significantly limits the prospects for successful recovery. Following the earthquake in Wenchuan, China, in May 2008, housing reconstruction was not immune to resource shortages and price inflation. Difficulties in sourcing materials and labour considerably impeded recovery. This paper provides evidence of the resourcing bottlenecks inherent in the post-Wenchuan earthquake reconstruction process. Its aim is to present an integrated planning framework for managing resources for post-disaster housing rebuilding. The results are drawn from in-field surveys that highlight the areas where stakeholders need to concentrate effort, including revising legislation and policy, enhancing capacity for rebuilding in the construction industry, strengthening the transportation network, restructuring market mechanisms, and incorporating environmental considerations into overall planning. Although the case study presented here is country-specific, it is hoped that the findings provide a basis for future research to identify resourcing constraints and solutions in other disaster contexts.     

Efficacy of stable isotope ratios in assigning endangered migrants to breeding and wintering sites.

A primary constraint on effective conservation of migratory animals is our inability to track individuals through their annual cycle. One such animal is the endangered southwestern subspecies of the Willow Flycatcher, which is difficult to distinguish from conspecifics. Identifying wintering regions used by the endangered subspecies would be an important step in formulating an effective conservation strategy. Our objective was to use stable isotope ratios as a means of identifying wintering sites of Southwestern Willow Flycatchers. We analyzed stable isotope ratios of carbon, nitrogen, and hydrogen from feathers of breeding and wintering Willow Flycatchers. Based on winter samples, we document a positive trend in hydrogen isotope ratios across latitude. We also found that Willow Flycatchers use C4 food webs south of 8 degrees N latitude, but we found no evidence of use of C4 food webs farther north. Nitrogen stable isotope ratios of feathers showed no discernable geographic variation. Discriminant function analyses, based on stable isotope ratios of wintering Willow Flycatchers, were only useful (>50% accurate) for assigning individuals to winter regions if the regions were large and the threshold probability for assignment was relatively high. When using these discriminant functions, most breeding samples of Southwestern Willow Flycatchers were assigned to two wintering regions: central Mexico and Ecuador. We think that assignment of Southwestern Willow Flycatchers to Ecuador is unrealistic. Given the large percentages of samples that could not be classified with certainty, we are not confident that these two regions are truly more likely to harbor wintering Southwestern Willow Flycatchers than other winter regions. We think our inconclusive results are due primarily to weak and nonlinear gradients in isotope ratios across the winter range of Willow Flycatchers.     

Spatio-temporal trends of PCBs in the Swedish freshwater environment 1981–2012

Polychlorinated biphenyls (PCBs) have been monitored in perch (Perca fluviatilis), pike (Esox lucius), and Arctic char (Salvelinus alpinus) in reference lakes since the late 1960s. Temporal trends and spatial patterns are currently monitored in nine and 32 lakes, respectively. Overall, PCB concentrations are decreasing. However, this is not consistent for all congeners across all lakes and species. Perch has comparatively low PCB concentrations relative to suggested target levels, but individual congener concentrations in some lakes are concerningly high. No temporal trend is seen for CB-118 and CB-153 in perch, but significant decreasing trends exist for Arctic char and pike, for which monitoring started earlier than for perch. The lower/higher chlorinated congener ratio decreased over time in most lakes, indicating fewer new emissions. CB-118 and CB-153 concentrations in perch show spatial gradients across Sweden, with higher concentrations found near urban/industrial areas.     

Soil Properties Predict Plant Community Development of Mitigation Wetlands Created in the Virginia Piedmont,USA

The study investigated vegetative and soil properties in four created mitigation wetlands, ranging in age from three to ten years, all created in the Virginia Piedmont. Vegetation attributes included percent cover, richness (S), diversity (H′), floristic quality assessment index (FQAI), prevalence index (PI), and productivity [i.e., peak above-ground biomass (AGB) and below-ground biomass]. Soil attributes included soil organic matter (SOM), gravimetric soil moisture (GSM), pH, and bulk density (D_b) for the top 10 cm. Species dominance (e.g., Juncus effusus, Scirpus cyperinus, Arthraxon hispidus) led to a lack of differences in vegetative attributes between sites. However, site-based differences were found for GSM, pH, and SOM (P < 0.001). Soil attributes were analyzed using Euclidean cluster analysis, resulting in four soil condition (SC) categories where plots were grouped based on common attribute levels (i.e., SC1 > SC2 > SC3 > SC4, trended more to less developed). When vegetation attributes were compared between SC groups, greater SOM, lower D_b, more circumneutral pH, and higher GSM, all indicative of maturation, were associated with higher H′ (P < 0.05), FQAI (P < 0.05), and total and volunteer percent cover (P < 0.05), and lower AGB (P < 0.001), PI (P < 0.05), and seeded percent cover (P < 0.05). The outcome of the study shows that site age does not necessarily equate with site development with soil and vegetation developmental rates varying both within and among sites. The inclusion of soil attributes in post-construction monitoring should be required to enhance our understanding and prediction of developmental trajectory of created mitigation wetlands.